Images in cardio-thoracic surgery. Obstructive mass in pulmonary artery.

A 62-year-old woman was admitted with syncope. A magnetic resonance imaging showed a 6-cm  3-cm mass on the pulmonary valve leaflet (Fig. 1). A 90 mmHg pressure gradient was found (Fig. 2). Angiogram revealed a severely calcified, mobile mass (Fig. 2, Videos 1 and 2), which was treated surgically. On histopathology analysis, a papillary fibro-elastoma diagnosis was confirmed. Fig. 1. Shows a 6 cm by 3 cm mass on the pulmonary valve leaflet at magnetic resonance image. Fig. 2. Shows a big mass on the pulmonary valve leaflet, severely calcified, mobile with no contrast enhancement (no contrast filling) and limited edges (A and B). The small picture shows a 65 mmHg pressure gradient between right ventricle and pulmonary artery (C).